From childhood through adolescence, we have found that prenatal alcohol exposure (PAE) predicts deficits in growth, morphology, and CNS development, the three domains that define Fetal Alcohol Syndrome. We have found these effects across the spectrum of alcohol use, demonstrating that PAE has significant effects at light, moderate, and high levels of exposure. This is particularly important to document in light of the still widespread belief that low-level alcohol consumption by pregnant women is safe. The majority of the women in our cohort drank at light and moderate levels, although we had drinkers across the spectrum of alcohol use. The number of low and moderate drinkers in our cohort has uniquely allowed us to identify the effects of low and moderate levels of alcohol exposure during gestation in addition to the effects of high levels of alcohol use, abuse, and binge drinking. Having data across the spectrum of use also gives us the ability to define the shape of the relations between PAE and the outcomes and to explore whether these associations are best modeled as dose-response or threshold relations. This proposal is to analyze data on the offspring and their mothers when the offspring are age 22. We will identify the effects of PAE at age 22, and we will integrate the 22-year assessment with the prior 10 phases to look at the trajectories of development from gestation through infancy, childhood, adolescence, and young adulthood. PUBLIC HEALTH RELEVANCE: Prenatal alcohol exposure has significant effects on the development of the central nervous system, growth, and morphology. At high levels of exposure, effects across these three domains lead to Fetal Alcohol Syndrome. Little is known about the effects of lower levels of alcohol exposure during gestation. This is a proposal to identify the effects of low and moderate, as well as heavy levels of prenatal alcohol exposure.